侵袭性肺曲霉菌病的MSCT表现

The multislice computed tomography(MSCT) findings of invasive pulmonary aspergillosis

目的:探讨侵袭性肺曲霉菌病的MSCT表现。方法:回顾性分析19例经病理证实的侵袭性肺曲霉菌病的MSCT表现。结果:MSCT表现为小结节影(1～3cm)14例(73.6%,14/19),大结节或团块影(>3cm)6例(31.6%,6/19);肺段或亚段分布的实变影8例(42.1%,8/19),磨玻璃影3例(15.8%,3/19);6例(31.6%,6/19)合并CT晕圈征,5例(26.3%,5/19)合并空气新月征或空洞影,2例(10.5%,2/19)可见中心低密度征,5例(26.3%,5/19)合并胸水。结论:侵袭性肺曲霉菌病的主要征象是单发或多发的结节伴空洞形成及肺段或亚段的实变,而出现结节晕圈征和空气新月征时,则高度提示侵袭性肺曲霉菌病。

Objective：To study the MSCT findings of invasive pulmonary aspergillosis（IPA） immunocompromised patients.Methods：Serial CT images of invasive pulmonary aspergillosis in immunocompromised patients were retrospectively reviewed.Results：Of the 19 cases,the main CT findings were：small nodules（1~3cm） 73.6%（14/19）,large nodules or masses（〉3cm） 31.6%（6/19）,consolidations either in segmental or subsegmental distribution 42.1%（8/19）,and ground glass opacity（GGO）15.8%（3/19）.An accompanying ＂halo＂ sign was observed in 6 patients（31.6%）,crescent sign or cavitation was encountered in 5 patients（26.3%）,two cases（10.5%） revealed hypodense sign on contrast enhanced CT scan images and 5（26.3%） accompanied by pleural effusion.Conclusions：CT findings of invasive pulmonary aspergillosis consist mainly of single or multiple nodules,cavities and segmental or subsegmental consolidation.In the appropriate clinical setting,the halo sign and the air crescent sign are highly suggestive for the diagnosis of IPA.